Healing at home

By Amber Hollingsworth | September 2022

Years ago when OHSU began to think about solutions to hospital bed capacity issues, providers understood that not all care needed to be delivered in the same way in the same place for all patients. They knew that healing could happen outside the walls of the hospital given the right conditions and right support.

Through a vibrant partnership with OHSU Family Medicine and Internal Medicine providers, nurses, hospitalists, pharmacists, lab technicians, paramedics, and the technology-enabled services company Medically Home that provides the infrastructure, OHSU’s Hospital at Home program was born. By combining virtual and in-person home care, patients can recover in their own homes with the help of their own providers.

“So far we’re hearing from patients that it’s a very positive experience,” said Family Medicine Director of Inpatient Care and Quality Jessie Flynn, M.D. “For a patient with a progressive disease, or a young person with serious medical illness, they can get so lonely staying in the hospital. They’re overjoyed to be at home instead.”

Hospital at Home isn’t for all patients – there are inclusion criteria beyond the patient’s diagnosis, like if they have a reliable adult in the home who can let hook up monitors and let technicians in. And it’s more than just a home visit or home health nurse situation – it’s for patients with a hospitalizable condition. We’re just able to translocate hospital-level care to their home.

Patients are provided with a router, an iPad, and other medical devices such as a blood pressure cuff delivered to their home. Providers, hospitalists, and nurses round to these patients virtually throughout the day. Paramedics can be deployed to do real-time physical assessments and perform basic EMT exams for stability. “We’ve also got phlebotomy, pharmacists, a meal delivery contractor that delivers healthy meals, couriers, portable x-ray technicians, and medical transportation to take patients to the hospital for events like CAT scans… there's a whole team of people who manage the logistical piece,” Flynn said.

The program went live in November 2021 with room for 20 enrolled patients and plans to expand. The current catchment area – Portland, most of Beaverton and Hillsboro – is determined by the vendors, so expansion will depend on new contracts. Flynn adds, “We’re very close to this being available for direct admissions so patients can bypass the emergency department and get a bed right away. It’s a great option for providers to keep in mind when they have patients who might be good candidates.”

For those outside of our catchment area, but who otherwise meet the Hospital at Home criteria, OHSU has set up a "home" for them at the Rood Pavilion.

This summer, the OHSU Professional Board recognized this incredible collaboration between teams, working together to figure out the workflows, contracts, licensing, and permits required to make this program happen. Dr. Flynn and her colleagues Ayako Mayo M.D., Jeremy Cook, M.S.N., Phil Gordon, M.B.A., and Stephanie Halvorson, M.D., received the 2022 Award for Innovation in New Models of Clinical Care and Interdisciplinary Teams. With Hospital at Home, more beds are available for those who need to be cared for at the hospital, while others can recover where they’re most comfortable.

Display of patient router, iPad, blood pressure cuff, and more items provided by OHSU.
The Hospital at Home tech/support setup for patients.